ICR Documents

Supporting Statement A Document Date Uploaded 1212-0072 Supporting Statement 2025.05.docx 05/09/2025 Supporting Statement B Document Date Uploaded Supplementary Documents Title Document Document Type Date Uploaded Justification of Nonmaterial Change Request_1212-0072 e-Filing Portal.02 Justification of Nonmaterial Change Request_1212-0072 e-Filing Portal.02.docx Justification for No Material/Nonsubstantive Change 11/20/2025 Justification for No Material or Nonsubstantive Change to Currently Approved Collection 1212-0072.03 Justification for No Material or Nonsubstantive Change to Currently Approved Collection 1212-0072.03.docx Justification for No Material/Nonsubstantive Change 07/28/2026 Proposed Edits to Request for Coverage Determination Instructions Proposed Edits to Request for Coverage Determination Instructions.pdf Justification for No Material/Nonsubstantive Change 07/28/2026 Proposed Edits to Request for Coverage Determination Form Proposed Edits to Request for Coverage Determination Form.pdf Justification for No Material/Nonsubstantive Change 07/28/2026 Public Comments Author Name Comment Document Author Affiliation Sponsoring Org. Type Category Date of Comment Date Comment Received